Self-fit hearing instruments with self-reported measures of hearing loss and listening

ABSTRACT

A processing system is configured to obtain data indicating answers of a user of one or more hearing instruments to a questionnaire. Additionally, the processing system is configured to determine an initial audiogram based on the answers. Furthermore, the processing system is configured to perform an initial fitting of the one or more hearing instruments based on the initial audiogram.

CROSS-REFERENCE TO RELATED APPLICATION

This Application claims the benefit of U.S. Provisional PatentApplication No. 62/835,886, filed Apr. 18, 2019, and U.S. ProvisionalPatent Application No. 62/887,369, filed Aug. 15, 2019, the entirecontent of each of which is incorporated by reference.

TECHNICAL FIELD

This disclosure relates to hearing instruments.

BACKGROUND

Hearing instruments are devices designed to be worn on, in, or near oneor more of a user's ears. Common types of hearing instruments includeheating assistance devices (e.g., “hearing aids”), earbuds, headphones,hearables, cochlear implants, and so on. In some examples, a hearinginstrument may be implanted or osseointegrated into a user. Some hearinginstruments include additional features beyond just environmentalsound-amplification. For example, some modern hearing instrumentsinclude advanced audio processing for improved device functionality,controlling and programming the devices, and beamforming, and some caneven communicate wirelessly with external devices including otherhearing instruments (e.g., for streaming media).

SUMMARY

This disclosure describes techniques for self-fitting of hearinginstruments with self-reported measures of hearing loss and listeningperception. Over-the-counter (OTC) and direct-to-consumer (DTC) heatingaid users are facing many technical challenges with existing selffitting strategies, especially for older users. Strategies that areintuitive to these users are desirable. In this disclosure, techniquesto self-fit hearing aids based on self-reported measures of hearing lossand listening perception are introduced. By filling out a shortquestionnaire and answering a few questions after listening with theOTC/DTC hearing aids, a user may be able to self-program the hearingaids to compensate his/her hearing loss with satisfaction. Although someportions of this disclosure describe examples with respect to hearingaids, such examples may apply to other types of hearing instruments.

In one example, this disclosure describes a method comprising:obtaining, by a processing system, data indicating answers of a user ofone or more hearing instruments to a questionnaire; determining, by theprocessing system, an initial audiogram based on the answers; andperforming, by the processing system, an initial fitting of the one ormore hearing instruments based on the initial audiogram.

In another example, this disclosure describes a computing systemcomprising: one or more computing devices, wherein one or moreprocessors and one or more communication units are included in the oneor more computing devices, the one or more communication units areconfigured to communicate with one or more hearing instruments, and theone or more processors are configured to: obtain data indicating answersof a user of the one or more hearing instruments to a questionnaire;determine an initial audiogram based on the answers; and perform aninitial fitting of the one or more hearing instruments based on theinitial audiogram.

In another example, this disclosure describes one or more processorsconfigured to: obtain data indicating answers of a user of the one ormore hearing instruments to a questionnaire; determine an initialaudiogram based on the answers; and perform an initial fitting of thehearing instrument based on the initial audiogram; and a receivercomprising one or more speakers for generating audible sound.

In another example, this disclosure describes a computer-readable datastorage medium having instructions stored thereon that when executedcause a processing system to: obtain data indicating answers of a userof one or more heating instruments to a questionnaire; determine aninitial audiogram based on the answers; and perform an initial fittingof the one or more hearing instruments based on the initial audiogram.

The details of one or more aspects of the disclosure are set forth inthe accompanying drawings and the description below. Other features,objects, and advantages of the techniques described in this disclosurewill be apparent from the description, drawings, and claims.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 is a conceptual diagram illustrating an example system thatincludes one or more hearing instrument(s), in accordance with one ormore techniques of this disclosure.

FIG. 2 is a block diagram illustrating example components of a hearinginstrument, in accordance with one or more aspects of this disclosure.

FIG. 3 is a block diagram illustrating example components of a computingdevice, in accordance with one or more aspects of this disclosure.

FIG. 4 is a flowchart illustrating an example operation in accordancewith one or more aspects of this disclosure.

FIG. 5 is a chart illustrating an example direct mapping from BetterHearing Institute (BHI) scores to audiograms.

FIG. 6 is a chart conceptually illustrating an initial audiogram for auser based on a BHI score for the user, in accordance with one or moreaspects of this disclosure.

FIG. 7 is an example scale for measuring self-reported loudness balancebetween two ears, accordance with one or more aspects of thisdisclosure.

FIG. 8 is an example scale for measuring self-reported overall loudness,in accordance with one or more aspects of this disclosure.

FIG. 9 is an example scale for measuring self-reported clarity, inaccordance with one or more aspects of this disclosure.

FIG. 10 is a flowchart illustrating an example operation in accordancewith one or more aspects of this disclosure.

DETAILED DESCRIPTION

FIG. 1 is a conceptual diagram illustrating an example system 100 thatincludes hearing instruments 102A, 102B, in accordance with one or moretechniques of this disclosure. This disclosure may refer to hearinginstruments 102A and 102B collectively, as “hearing instruments 102.” Auser 104 may wear hearing instruments 102. In some instances, such aswhen user 104 has unilateral hearing loss, user 104 may wear a singlehearing instrument. In other instances, such as when user 104 hasbilateral hearing loss, the user may wear two hearing instruments, withone hearing instrument for each ear of the user.

Hearing instruments 102 may comprise one or more of various types ofdevices that are configured to provide auditory stimuli to a user andthat are designed for wear and/or implantation at, on, or near an ear ofthe user. Hearing instruments 102 may be worn, at least partially, inthe ear canal or concha. One or more of hearing instruments 102 mayinclude behind the ear (BTE) components that are worn behind the ears ofuser 104. In some examples, hearing instruments 102 comprise devicesthat are at least partially implanted into or osseointegrated with theskull of the user. In some examples, one or more of hearing instruments102 is able to provide auditory stimuli to user 104 via a boneconduction pathway.

In any of the examples of this disclosure, each of hearing instruments102 may comprise a hearing assistance device. Hearing assistance devicesinclude devices that help a user hear sounds in the user's environment.Example types of hearing assistance devices may include hearing aiddevices, Personal Sound Amplification Products (PSAPs), cochlear implantsystems (which may include cochlear implant magnets, cochlear implanttransducers, and cochlear implant processors), and so on. In someexamples, hearing instruments 102 are over-the-counter,direct-to-consumer, or prescription devices. Furthermore, in someexamples, hearing instruments 102 include devices that provide auditorystimuli to the user that correspond to artificial sounds or sounds thatare not naturally in the user's environment, such as recorded music,computer-generated sounds, or other types of sounds. For instance,hearing instruments 102 may include so-called “hearables,” earbuds,earphones, or other types of devices. Some types of hearing instrumentsprovide auditory stimuli to the user corresponding to sounds from theuser's environment and also artificial sounds.

In some examples, one or more of hearing instruments 102 includes ahousing or shell that is designed to be worn in the ear for bothaesthetic and functional reasons and encloses the electronic componentsof the hearing instrument. Such hearing instruments may be referred toas in-the-ear (ITE), in-the-canal (ITC), completely-in-the-canal (CIC),or invisible-in-the-canal (IIC) devices. In some examples, one or moreof hearing instruments 102 may be behind-the-ear (BTE) devices, whichinclude a housing worn behind the ear that contains all of theelectronic components of the hearing instrument, including the receiver(i.e., the speaker). The receiver conducts sound to an earbud inside theear via an audio tube. In some examples, one or more of hearinginstruments 102 may be receiver-in-canal (RIC) hearing-assistancedevices, which include a housing worn behind the ear that containselectronic components and a housing worn in the ear canal that containsthe receiver.

Hearing instruments 102 may implement a variety of features that helpuser 104 hear better. For example, hearing instruments 102 may amplifythe intensity of incoming sound, amplify the intensity of certainfrequencies of the incoming sound, or translate or compress frequenciesof the incoming sound. In another example, hearing instruments 102 mayimplement a directional processing mode in which hearing instruments 102selectively amplify sound originating from a particular direction (e.g.,to the front of the user) while potentially fully or partially cancelingsound originating from other directions. In other words, a directionalprocessing mode may selectively attenuate off-axis unwanted sounds. Thedirectional processing mode may help users understand conversationsoccurring in crowds or other noisy environments. In some examples,hearing instruments 102 may use beamforming or directional processingcues to implement or augment directional processing modes.

In some examples, hearing instruments 102 may reduce noise by cancelingout or attenuating certain frequencies. Furthermore, in some examples,hearing instruments 102 may help user 104 enjoy audio media, such asmusic or sound components of visual media, by outputting sound based onaudio data wirelessly transmitted to hearing instruments 102.

Hearing instruments 102 may be configured to communicate with eachother, For instance, in any of the examples of this disclosure, hearinginstruments 102 may communicate with each other using one or morewirelessly communication technologies. Example types of wirelesscommunication technology include Near-Field Magnetic Induction (NFMI)technology, a 900 MHz technology, a BLUETOOTH™ technology, a WI-FI™technology, audible sound signals, ultrasonic communication technology,infrared communication technology, an inductive communicationtechnology, or another type of communication that does not rely on wiresto transmit signals between devices. In some examples, hearinginstruments 102 use a 2.4 GHz frequency band for wireless communication.In some examples of this disclosure, hearing instruments 102 maycommunicate with each other via non-wireless communication links, suchas via one or more cables, direct electrical contacts, and so on.

As shown in the example of FIG. 1, system 100 may also include acomputing system 108. In other examples, system 100 does not includecomputing system 108. Computing system 108 comprises one or morecomputing devices, each of which may include one or more processors. Forinstance, computing system 108 may comprise one or more mobile devices,server devices, personal computer devices, handheld devices, wirelessaccess points, smart speaker devices, smart televisions, medical alarmdevices, smart key fobs, smartwatches, smartphones, motion or presencesensor devices, smart displays, screen-enhanced smart speakers, wirelessrouters, wireless communication hubs, prosthetic devices, mobilitydevices, special-purpose devices, accessory devices, and/or other typesof devices. Accessory devices may include devices that are configuredspecifically for use with hearing instruments 102. Example types ofaccessory devices may include charging cases for hearing instruments102, storage cases for hearing instruments 102, media streamer devices,phone streamer devices, external microphone devices, remote controls forhearing instruments 102, and other types of devices specificallydesigned for use with hearing instruments 102. Actions described in thisdisclosure as being performed by computing system 108 may be performedby one or more of the computing devices of computing system 108. One ormore of hearing instruments 102 may communicate with computing system108 using wireless or non-wireless communication links. For instance,hearing instruments 102 may communicate with computing system 108 usingany of the example types of communication technologies describedelsewhere in this disclosure.

FIG. 2 is a block diagram illustrating example components of hearinginstrument 200, in accordance with one or more aspects of thisdisclosure. Hearing instrument 200 may be either one of hearinginstruments 102 (FIG. 1). In the example of FIG. 2, hearing instrument200 comprises one or more storage devices 202, one or more communicationunits 204, a receiver 206. one or more processors 208, one or moremicrophones 210, a set of sensors 212, a power source 214, and one ormore communication channels 216. Communication channels 216 providecommunication between storage devices 202, communication unit(s) 204,receiver 206, processor(s) 208, a microphone(s) 210, and sensors 212.Components 202, 204, 206, 208, 210, and 212 may draw electrical powerfrom power source 214.

In the example of FIG. 2, each of components 202, 204, 206, 208, 210,212, 214, and 216 are contained within a single housing 218. However, inother examples of this disclosure, components 202, 204, 206, 208, 210,212, 214, and 216 may be distributed among two or more housings. Forinstance, in an example where hearing instrument 200 is a RIC device,receiver 206 and one or more of sensors 212 may be include in an in-earhousing separate from a behind-the-ear housing that contains theremaining components of hearing instrument 200. In such examples, a RICcable may connect the two housings.

Furthermore, in the example of FIG. 2, sensors 212 include an inertialmeasurement unit (IMU) 226 that is configured to generate data regardingthe motion of hearing instrument 200. IMU 226 may include a set ofsensors. For instance, in the example of FIG. 2, IMU 226 includes one ormore of accelerometers 228, a gyroscope 230, a magnetometer 232,combinations thereof, and/or other sensors for determining the motion ofhearing instrument 200. Furthermore, in the example of FIG. 2, hearinginstrument 200 may include one or more additional sensors 236.Additional sensors 236 may include a photoplethysmography (PPG) sensor,blood oximetry sensors, blood pressure sensors, electrocardiograph (EKG)sensors, body temperature sensors, electroencephalography (EEG) sensors,environmental temperature sensors, environmental pressure sensors,environmental humidity sensors, skin galvanic response sensors, and/orother types of sensors. In other examples, hearing instrument 200 andsensors 212 may include more, fewer, or different components.

Storage devices 202 may store data. Storage devices 202 may comprisevolatile memory and may therefore not retain stored contents if poweredoff. Examples of volatile memories may include random access memories(RAM), dynamic random access memories (DRAM), static random accessmemories (SRAM), and other forms of volatile memories known in the art.Storage devices 202 may further be configured for long-term storage ofinformation as non-volatile memory space and may retain informationafter power on/off cycles. Examples of non-volatile memoryconfigurations may include magnetic hard discs, optical discs, floppydiscs, flash memories, or forms of electrically programmable memories(EPROM) or electrically erasable and programmable (EEPROM) memories.

Communication unit(s) 204 may enable hearing instrument 200 to send datato and receive data from one or more other devices, such as anotherhearing instrument, an accessory device, a mobile device, or anothertypes of device. Communication unit(s) 204 may enable hearing instrument200 using wireless or non-wireless communication technologies. Forinstance, communication unit(s) 204 enable hearing instrument 200 tocommunicate using one or more of various types of wireless technology,such as a BLUETOOTH™ technology, 3G, 4G, 4G LTE, 5G, ZigBee, WI-FI™,Near-Field Magnetic Induction (NFMI), ultrasonic communication, infrared(IR) communication, or another wireless communication technology. Insome examples, communication unit(s) 204 may enable hearing instrument200 to communicate using a cable-based. technology, such as a UniversalSerial Bus (USB) technology.

Receiver 206 comprises one or more speakers for generating audiblesound. Microphone(s) 210 detects incoming sound and generates one ormore electrical signals (e.g., an analog or digital electrical signal)representing the incoming sound.

Processor(s) 208 may be processing circuits configured to performvarious activities. For example, processor(s) 208 may process the signalgenerated by microphone(s) 210 to enhance, amplify, or cancel-outparticular channels within the incoming sound. Processor(s) 208 may thencause receiver 206 to generate sound based on the processed signal. Insome examples, processor(s) 208 include one or more digital signalprocessors (DSPs). In some examples, processor(s) 208 may causecommunication unit(s) 204 to transmit one or more of various types ofdata. For example, processor(s) 208 may cause communication unit(s) 204to transmit data to computing system 108. Furthermore, communicationunit(s) 204 may receive audio data from computing system 108 andprocessor(s) 208 may cause receiver 206 to output sound based on theaudio data.

FIG. 3 is a block diagram illustrating example components of computingdevice 300, in accordance with one or more aspects of this disclosure.FIG. 3 illustrates only one particular example of computing device 300,and many other example configurations of computing device 300 exist.Computing device 300 may be a computing device in computing system 108(FIG. 1).

As shown in the example of FIG. 3, computing device 300 includes one ormore processor(s) 302, one or more communication unit(s) 304, one ormore input device(s) 308, one or more output device(s) 310, a displayscreen 312, a power source 314, one or more storage device(s) 316, andone or more communication channels 318. Computing device 300 may includeother components. For example, computing device 300 may include physicalbuttons, microphones, speakers, communication ports, and so on.Communication channel(s) 318 may interconnect each of components 302,304, 308, 310, 312, and 316 for inter-component communications(physically, communicatively, and/or operatively). In some examples,communication channel(s) 318 may include a system bus, a networkconnection, an inter-process communication data structure, or any othermethod for communicating data. Power source 314 may provide electricalenergy to components 302, 304, 308, 310, 312 and 316.

Storage device(s) 316 may store information required for use duringoperation of computing device 300. In some examples, storage device(s)316 have the primary purpose of being a short term and not a long-termcomputer-readable storage medium. Storage device(s) 316 may be volatilememory and may therefore not retain stored contents if powered off.Storage device(s) 316 may further be configured for long-term storage ofinformation as non-volatile memory space and may retain informationafter power on/off cycles. In some examples, processor(s) 302 ofcomputing device 300 may read and execute instructions stored by storagedevice(s) 316.

Computing device 300 may include one or more input device(s) 308 thatcomputing device 300 uses to receive user input. Examples of user inputinclude tactile, audio, and video user input. Input device(s) 308 mayinclude presence-sensitive screens, touch-sensitive screens, mice,keyboards, voice responsive systems, microphones or other types ofdevices for detecting input from a human or machine.

Communication unit(s) 304 may enable computing device 300 to send datato and receive data from one or more other computing devices (e.g., viaa communications network, such as a local area network or the Internet).For instance, communication unit(s) 304 may be configured to receivedata exported by hearing instrument(s) 102, receive data generated byuser 104 of hearing instrument(s) 102, receive and send request data,receive and send messages, and so on. In some examples, communicationunit(s) 304 may include wireless transmitters and receivers that enablecomputing device 300 to communicate wirelessly with the other computingdevices. For instance, in the example of FIG. 3, communication unit(s)304 include a radio 306 that enables computing device 300 to communicatewirelessly with other computing devices, such as hearing instruments 102(FIG. 1). Examples of communication unit(s) 304 may include networkinterface cards, Ethernet cards, optical transceivers, radio frequencytransceivers, or other types of devices that are able to send andreceive information. Other examples of such communication units mayinclude BLUETOOTH™, 3G, 4G, 5G, and WI-FI™ radios, Universal Serial Bus(USB) interfaces, etc. Computing device 300 may use communicationunit(s) 304 to communicate with one or more hearing instruments (e.g.,hearing instrument 102 (FIG. 1, FIG. 2)). Additionally, computing device300 may use communication unit(s) 304 to communicate with one or moreother remote devices.

Output device(s) 310 may generate output. Examples of output includetactile, audio, and video output. Output device(s) 310 may includepresence-sensitive screens, sound cards, video graphics adapter cards,speakers, liquid crystal displays (LCD), or other types of devices forgenerating output.

Processor(s) 302 may read instructions from storage device(s) 316 andmay execute instructions stored by storage device(s) 316. Execution ofthe instructions by processor(s) 302 may configure or cause computingdevice 300 to provide at least some of the functionality ascribed inthis disclosure to computing device 300. As shown in the example of FIG.3, storage device(s) 316 include computer-readable instructionsassociated with operating system 320, application modules 322A-322N(collectively, “application modules 322”), and a companion application324. Additionally, in the example of FIG. 3, storage device(s) 316 maystore health-related data 326.

Execution of instructions associated with operating system 320 may causecomputing device 300 to perform various functions to manage hardwareresources of computing device 300 and to provide various common servicesfor other computer programs. Execution of instructions associated withapplication modules 322 may cause computing device 300 to provide one ormore of various applications (e.g., “apps,” operating systemapplications, etc.). Application modules 322 may provide particularapplications, such as text messaging (e.g., SMS) applications, instantmessaging applications, email applications, social media applications,text composition applications, and so on.

Execution of instructions associated with companion application 324 byprocessor(s) 302 may cause computing device 300 to perform one or moreof various functions. For example, execution of instructions associatedwith companion application 324 may cause computing device 300 toconfigure communication unit(s) 304 to receive data from hearinginstruments 102 or other sources and use the received data to presentdata (e.g., health-related data, fitting-related data, etc.) to a user,such as user 104 or a third-party user. In some examples, companionapplication 324 is an instance of a web application or serverapplication. In some examples, such as examples where computing device300 is a mobile device or other type of computing device, companionapplication 324 may be a native application.

Currently, hearing instruments, such as hearing aids, can only be fittedby a hearing healthcare professional. Fitting of a hearing instrument,such as a hearing aid, is a process of adjusting output parameters ofthe hearing instrument for an individual user. For instance, fitting ofa hearing instrument may involve increasing the output levels of ahearing instrument by particular amounts for particular frequency bands,while potentially keeping output levels of the hearing instrumentconstant at other frequency bands. A fitting of a hearing instrument mayrefer to the set of output parameters determined by fitting the hearinginstrument. Hearing instruments 102 may modify received sound accordingto the output parameters and receivers of hearing instruments 102 outputthe received sound for hearing by user 104. For instance, the outputparameters may control how hearing instruments 102 amplify the intensityof incoming sound, amplify the intensity of certain frequencies of theincoming sound, translate and/or compress frequencies of the incomingsound, and so on.

Recent legislation from the U.S. Food and Drug Administration (FDA) willbegin a new era of providing over-the-counter (OTC) anddirect-to-consumer (DTC) hearing aids to hearing-impaired individuals.This presents a challenge of how to ensure users are able toappropriately program their hearing instruments without specializedequipment and a professional. This challenge is especially critical forolder users. Many currently-available self-fitting strategies use eitherpreset gain-frequency responses or initial programming based on ahearing test conducted through a web page or mobile application. Thesehearing tests often require calibration of transducers (headphones orearbuds), which may be a potentially difficult process for older users.Moreover, fine adjustments to meet individual preferences typicallyrequire users to manipulate many aspects of sound, such as bass, treble,overall loudness, with a control interface (e.g., a remote control or amobile app). Without professional guidance, fine adjustments using acontrol interface across these different aspects of sound may result insub-optimal or undesirable gain-frequency responses, which may leaveusers frustrated and unsatisfied.

Some self-fitting hearing instruments (e.g., personal soundamplification products) allow their users to select among a few presetsto get something that sounds good to the users. These presets are oftenbased on the degree and configuration of hearing loss, e.g., mild,mild-to-moderate, flat, moderate sloping. Because amplificationprescriptions are frequency specific, estimating hearing thresholds viaa hearing test is another common strategy that some products implement.Using a mobile app, web portal, or the device itself, speech orpure-tone signals are presented to the listener via a pair ofheadphones. The results are used to program the hearing instruments.With either a preset or results from a hearing test, a user only getsthe initial fitting. Fine adjustments may still be needed to meetindividual's needs and preferences. Some hearing instruments allow themanipulation of acoustic parameters in a manner that is common in theaudio industry (e.g., through volume controls, equalizer sliders andtone controls), while other hearing instruments provide user interfacesfor manipulating multiple variables behind-the-scenes (e.g., gain,frequency response and compression).

Challenges still remain in fitting hearing instruments to individualusers. For example, it still may be difficult for users to fit theirhearing instruments to their individual preferences. This disclosuredescribes techniques that may improve the ability of hearing instruments102 (FIG. 1) to be fitted to individual users. As described herein, thetechniques may use one or more self-reported measures to obtain theinitial settings and make fine adjustments for individual preferences.Use of the techniques may make it easier for user 104 to fit hearinginstruments 102 to the preferences of user 104.

FIG. 4 is a flowchart illustrating an example operation of a processingsystem for fitting hearing instruments 102, in accordance with one ormore aspects of this disclosure. The flowcharts of this disclosure areprovided as examples. Other examples may include more, fewer, ordifferent actions; or actions may be performed in different orders or inparallel. Although FIG. 4 and other parts of this disclosure arediscussed as being performed with respect to hearing instruments 102, itis to be understood that much of this discussion is applicable in caseswhere user 104 only uses a single hearing instrument.

In the example of FIG. 4, a processing system (e.g., one or moreprocessors of hearing instruments 102, one or more processors ofcomputing system 108, processor(s) 208 of hearing instrument 200,processor(s) 302 of computing device 300. or a combination of two ormore of these) may perform actions (400) through (406) to determine aninitial fitting for hearing instruments 102. In some examples, thedetermined initial fitting may be the best-possible initial fitting foruser 104.

Particularly, in the example of FIG. 4, the processing system mayreceive data indicating the answers of user 104 to a questionnaire. Insome examples, user 104 fills out a questionnaire. For instance, in someexamples, companion application 324 may output a user interface fordisplay for user 104 or another user. The user interface may receiveindications of user input of the answers to the questionnaire.

An example of such a questionnaire is the Better Hearing Institute (BHI)Quick Hearing Check questionnaire (Kochkin & Bentler, “The validity andreliability of the BHI Quick Hearing Check,” Hearing Review, 17(12),12-28 2010 (hereinafter, “Kochkin & Bentler 2010”)). The BHI QuickHearing Check questionnaire is a 15 item, 5-point (0-4) Likert-scaledquestionnaire, which has been used to quantify and segment people onsubjective hearing loss. The possible questionnaire score range is from0 to 60. Another example questionnaire may be found athttps://hearinghealthmatters.org/waynesworld/2017/hearing-self-test/.For ease of explanation, this disclosure makes reference to the BHIquestionnaire and BHI scores, but other questionnaires and scores mayapply. In the example of FIG. 4, the processing system may compute,based on the answers of user 104 to the questionnaire, a BHI score foruser 104 (402). The processing system may compute the BHI score for user104 in the standard manner for the BHI questionnaire.

In some examples, the processing system directly maps the results of thequestionnaire to an audiogram. An example of direct mapping between aquestionnaire (e.g. the BHI) score and an audiogram is shown in FIG. 5.In other words, FIG. 5 is a chart illustrating an example direct mappingfrom BHI scores to audiograms. In the example of FIG. 5, differentlydashed lines correspond to different audiograms and the differentaudiograms correspond to different BHI score ranges. The audiogramsshown in FIG. 5 and the specific mappings shown are for illustrationpurposes only, and different audiograms and/or mappings to the BHIresults (or the results of some other questionnaire) could be derived.

In other examples, the processing system uses indirect mapping of theresults of the questionnaire to an audiogram. For example, the BHI scorecomputed for the user based on the results of the questionnaire maycorrespond to two or more of audiological test scores. In this case, the“audiological test” may include any of a number of standardized tests,including: 2-, 3-, 4-, 5-, or x-frequency pure-tone averages (PTAs),speech reception thresholds (SRTs), word recognition scores (WRSs),speech recognition in noise scores (e.g., quick speech in noise testscores), otoacoustic emission amplitudes (OAEs), evoked potentialresults (e.g. auditory brainstem responses (ABRs) (amplitude orlatencies), electroencephalogram (EEG) responses) or some other metric.

Thus, in accordance with the techniques of this disclosure, theprocessing system may map the results of the questionnaire to theresults of two or more audiological test results, and may then determinean audiogram that is a best match to those audiological test resultsbased on a calculated distance (e.g., a Euclidean distance, a Manhattandistance, etc.). While direct mapping between questionnaire results andpredicted hearing thresholds may be the simpler, indirect mapping may bebeneficial in scenarios in which a direct mapping between anindividual's questionnaire results and his/her hearing thresholds is notknown.

As an example of an indirect mapping, Kochkin S, Bender R., “Thevalidity and reliability of the BHI Quick Hearing Check”, HearingReview, 2010; 17(12):12-28, identified a speech reception threshold(SRT) and a five-frequency PTA score (which is an average of hearingthresholds at 500, 1000, 2000, 3000, and 4000 Hz) that correspond toeach possible BHI score. Because SRTs are highly correlated with hearingthresholds in the low frequencies (e.g. 500, 1000 and 2000 Hz)(Smoorenburg, “Speech reception in quiet and in noisy conditions byindividuals with noise-induced hearing loss in relation to their toneaudiogram”. The journal of the acoustical society of America, 91(1),421-437 (1992)), SRTs can be assumed to be a proxy for a 3-frequency PTAscore. As such, each BHI score can be mapped to a two-dimensional space,with the 3-frequency PTA score corresponding to each score on the x-axisand the 5-frequency PTA score for each BHI score on the y-axis. Thisallows each BHI score to be compared to the 3-frequency and 5-frequencyPTA scores of a set of standard audiograms to determine the closestmatch. In another example, if the exact relationship between the set ofstandard audiograms and the SRTs had been established, then SRTs may beplotted directly on the x-axis with 5-frequency PTA scores on they-axis. However, for the remainder of the disclosure, it is assumed thatthe SRTs have been converted to 3-frequency PTAs unless otherwise noted.

Sets of standard audiograms have been defined. For example, theInternational Electrotechnical Commission (IEC) standard provides 60standard audiograms for hearing aid testing (Bisgaard et al., 2010). Inanother example, the IEC has also developed a set of 12 standardaudiograms and a set of 10 standard audiograms (7 for flat andmoderately sloping hearing loss profiles and 3 for steeply slopinghearing loss profiles). In some examples, the standard audiograms arespecific to a hearing instrument manufacturer or defined by anotherstandard-setting organization. Each of the possible BHI scores may bemapped to one of the 60 standard audiograms. In the example of FIG. 4,the processing system may determine an initial audiogram for user 104based on the BHI score for user 104 (404). The initial audiogram foruser 104 may be a standard audiogram in a set of standard audiograms.For example, the initial audiogram for user 104 may be one of the 60standard audiograms defined by the IEC for hearing aid testing. Thedetermined initial audiogram may be an optimal initial audiogram forfitting hearing instruments 102. The processing system may performinitial fitting of hearing instruments 102 based on the initialaudiogram for user 104 (406). For instance, the processing system mayset output parameters of hearing instruments 102 to compensate forhearing loss associated with the initial audiogram for user 104. In someexamples, one or more processors of computing system 108 (e.g.,processor(s) 302 of computing device 300) may send the output parametersto hearing instruments 102 (e.g., using communication unit(s) 304 ofcomputing device 300),

In some examples, the process for determining the initial audiogram foruser 104 is based on a calculated distance (e.g., Euclidean distance,Manhattan distance, etc.) between BHI-estimated PTA scores and standardaudiogram PTA scores. In such examples, the processing system calculatesthe distance between a BHI-estimated PTA score data point for user 104and the PTA scores of one or more (e.g., each, a plurality, a subset,etc.) of the standard audiograms. The processing system selects theclosest standard audiogram to the BHI-estimated PTA score data point foruser 104 as the initial audiogram for user 104.

FIG. 6 is a chart 600 conceptually illustrating an example fordetermining an initial audiogram for user 104 based on a BHI score foruser 104, in accordance with one or more aspects of this disclosure. Oneaxis of chart 600 corresponds to 3PTA values and the other axis of chart600 corresponds to 5PTA values. In other examples, one axis of chart 600may correspond to SRT scores and the other axis of chart 600 correspondsto 5PTA scores. In the example of FIG. 6, points 602A, 602B, 602C, and602C (collectively, “points 602”) correspond to four standardaudiograms. In other examples, the processing system may use additionalpoints for additional standard audiograms. Furthermore, in the exampleof FIG. 6, the chart includes a point 604 (labeled “BHI score-basedPTAs”) corresponding to the BHI score of user 104.

In the example of FIG. 6, the processing system may calculate thedistances 606A-606D (collectively, “distances 606”) from the BHI scoredata point to each of the four standard audiogram data points 602. Thedistance between the data point 604 for the BHI score and the data point602C for standard audiogram #3 is the shortest, which means that thehearing loss estimated by the BHI questionnaire is closest to standardaudiogram #3. Therefore, a user with these BHI-estimated 3PTA and 5PTAscores (e g., user 104) may have their hearing instruments (e.g.,hearing instruments 102) initially programmed to standard audiogram #3.In the example of FIG. 6, the processing system may map a BHI score to astandard audiogram based on a distance measure. In this example, thisBHI score corresponds to a pair of PTA values, which is indicated by adiamond shape. According to distance, standard audiogram #3 has theshortest distance and the processing system uses audiogram #3 forinitial fitting.

If more than two or more audiograms are equally distant from theBHI-PTAs (e.g., from point 604), the processing system may determinewhich of the equally distant audiograms to use. In this disclosure, anaudiogram may be considered to have a distance equal to a distancebetween a point corresponding to the audiogram and a point correspondingto the BHI score data point. In some examples, the processing systemmakes such a decision based on information about which one of theequally-distant audiograms is more prevalent in a population. In thisexample, the processing system may use the most prevalent of the equallydistant audiograms for initial fitting of hearing instruments 102.

In some examples, the processing system may determine which of theequally distant audiograms to use based on whether user 104 is a newhearing instrument user or is currently a user of a hearing instrument.For instance, if user 104 is currently a user of a hearing instrument,the processing system may select whichever of the equally distantaudiograms is a closest match to an audiogram of the user's currenthearing instrument. Thus, in some examples, based on a determinationthat coordinate values for two or more audiograms in the plurality ofaudiograms are equally distant from the determined coordinate values,the processing system may determine which of the two or more audiogramsto use as the initial audiogram based on whether the user is a newhearing instrument user or is currently a hearing instrument user.

In some examples, the processing system may determine which of theequally distant audiograms to use based on responses of a user to one ormore additional questions and/or based on a subset of the questions inthe questionnaire. In some examples, when two or more of the audiogramsare equally distant from the BHI-PTAs, the processing system maydetermine an average of the two or more equally distant audiograms. Theprocessing system may use the average of the two or more equally-distantaudiograms as the initial audiogram for user 104.

Referring back to FIG. 4, after initial programming, the processingsystem may perform actions (408) and (410) to make fine-tuningadjustments to customize the fitting to the preferences of user 104. Forinstance, in the example of FIG. 4, the processing system may obtaininformation about listening perception of sound generated by hearinginstruments 102 (408). The processing system may perform a refinedfitting based on the information about the listening perception of thesound generated by hearing instruments 102 (410).

Obtaining the information about the listening perception of soundgenerated by hearing instruments 102 may involve a question-drivenautomatic adjustment system. User 104 may be asked (e.g., by theprocessing system, by printed instructions, by a person, etc.) to listento speech in a quiet situation (e.g., while watching the news at home)and user 104 is then presented with a series of questions. In someexamples, a device (e.g., hearing instruments 102, a smartphone of user104, etc.) may analyze a current acoustic environment of user 104 tohelp ensure that user 104 is in an appropriately quiet situation. Forexample, the device may output audio indications of whether user 104 isin an appropriately quiet situation. In some examples, a smartphone mayoutput a sound level meter for display and instruct user 104 to move toor adjust the acoustic environment of user 104 so that user 104 is in anappropriately quiet situation. In some examples, hearing instruments 102may output an audible indication to user 104 instructing user 104 tomove to or adjust the acoustic environment of user 104 so that user 104is in an appropriately quiet situation. Answers to the questions maycorrespond to values on numeral scales. In some examples, companionapplication 324 may output a user interface for display. The userinterface presented by companion application 324 may receive indicationsof user input of the answers to questions regarding the listeningperception of the sound generated by hearing instruments 102.

FIG. 7 is an example scale for measuring self-reported loudness balancebetween two ears, accordance with one or more aspects of thisdisclosure. FIG. 8 is an example scale for measuring self-reportedoverall loudness, in accordance with one or more aspects of thisdisclosure. FIG. 9 is an example scale for measuring self-reportedclarity, in accordance with one or more aspects of this disclosure.

As shown in the example of FIG. 7, the questions may include one or morequestions regarding the loudness balance of sound generated by hearinginstruments 102 between the two ears of user 104. As shown in theexample of FIG. 8, the questions may include one or more questionsregarding overall loudness of sound generated by hearing instruments102. As shown in the example of FIG. 9, the questions may includequestions regarding whether the sound produced by hearing instruments102 is “tinny” or “boomy” (FIG. 9).

The rating for each of the questions may correspond to predeterminedgain changes. For example, if the answer to the question in FIG. 7indicates that the left ear is “much louder,” the processing system maydecrease the overall gain of the left hearing instrument by a firstpredetermined amount (e.g., 3 dB); if the answer to the question of FIG.7 indicates that the left ear is “slightly louder,” the processingsystem may decrease the overall gain for the left hearing instrument bya second predetermined amount (e.g., 1.5 dB); and so on. Furthermore, insome examples, if the overall loudness rating is “Loud,” then theoverall gain will be reduced by 3 dB. The user may use these samequestions multiple times until the answer to question (1) is “Equallyloud,” the answer to question (2) is “Comfortable,” and the answer toquestion (3) is “Clear” (neither “tinny” nor “boomy”). With respect tothe example of FIG. 9, the processing system may decrease gain for oneor more high-frequency bands by a first predetermined amount if theanswer is “tinny,” by a second predetermined amount if the answer is“slightly tinny”; the processing system may decrease gain for one ormore low-frequency bands by a third predetermined amount if the answeris “boomy” and by a fourth predetermined amount if the answer is“slightly boomy.” The processing system may receive an indication of theuser's response to these questions. In some examples, actions (408) and(410) may be performed multiple times in order to continue refining thefitting for user 104. In some examples, during subsequent performancesof actions (408) and (410), the processing system may use different(e.g., smaller, greater) predetermined values. The resulting hearinginstrument settings conclude the refined fitting.

Although the BHI questionnaire is used as an example above, theprocessing system may use the results of other questionnaires to performthis function, so long as the results of the other questionnaires may bemapped to a database of common audiograms.

Furthermore, as an alternative to the standard audiograms, norms may becreated by using the actual audiograms from a database of people whohave taken the BHI (or another) questionnaire, and these could be usedto program the hearing aids. For example, after user 104 has arrived ata refined fitting (e.g., after one or more rounds of actions 408 and410), the processing system may add an audiogram corresponding to therefined fitting for user 104 to the set of “standard” audiograms. Thus,if another user's BHI score corresponds to PTA values closer to the PTAvalues corresponding to the BHI score of user 104 than PTA values ofother “standard” audiograms, the audiogram corresponding to therefinement fitting for user 104 may be used as the initial audiogram forthe other user.

Once the BHI score (or the standard audiogram to which it maps) for user104 is determined, the result may be used to program hearing instruments102. There are many ways in which the processing system may determinethe BHI score for user 104. For instance, in the following examples,voice recognition may be used:

-   -   Hearing instruments 102 may be configured to ask user 104 what        his/her BHI score is (or the standard audiogram that it maps        to), and he/she responds verbally.    -   Hearing instruments 102 may be configured to ask user 104 if        his/her BHI score (or the standard audiogram # that it maps to)        is within a certain range, and user 104 may nod/shake his/her        head when the answer is yes; for example:        -   If the BHI score (or audiogram #) was 33, hearing            instruments 102 may ask. “Is the BHI score (or audiogram #)            0-9?” (User 104 may either shake his/her head no or makes no            response.) After a few seconds, hearing instruments 102 may            ask “Is the BHI score (or audiogram #) 10-19?” (User 104            then either shakes his/her head no or makes no response.)            After a few seconds, hearing instruments 102 may ask “Is the            BHI score (or audiogram #) 20-29?” (User 104 either shakes            his/her head no or makes no response.) After a few seconds,            hearing instruments 102 may ask “Is the BHI score (or            audiogram #) 30-39?” (User 104 nods yes.) Hearing            instruments 102 may then perform a similar process until the            correct exact audiogram number is identified.        -   Potentially, ranges for the most common BHI scores (or            audiograms) could be listed first to minimize the number of            responses that most people need to give.

In some examples, hearing instruments 102 may ask user 104 if his/herBHI score (or the standard audiogram that it maps to) is within acertain range, and user 104 may press a button on hearing instruments102 when the answer is yes (following the example above). In someexamples, hearing instruments 102 ask user 104 if his/her BHI score (orthe standard audiogram that it maps to) is within a certain range, anduser 104 taps on hearing instruments 102 (e.g. via a double tap) whenthe answer is yes (following the example above).

In some examples, presets are programmed into hearing instruments 102and user 104 navigates to (e.g. via a manual control) a given preset;he/she then performs some function (e.g., pushing and holding a button)to save that preset into hearing instruments 102. If many presets exist,user 104 may have the option of scrolling through presets quickly (e.g.,by using a rotary wheel or holding down a button).

In some examples, user 104 uses a remote control to enter the results ofthe BHI questionnaire (or the audiogram that it maps to). The remotecontrol may communicate with hearing instruments 102 to program hearinginstruments 102.

In some examples, user 104 completes the questionnaire within anapplication (e.g., a native application, a web application, etc.) thatautomatically programs hearing instruments 102 based on the results. Insome examples, user 104 completes a paper-and-pencil questionnaire andthen enters the result into an application (e.g., a native application,a web application, etc.). In this way, the processing system may obtaindata indicating answers to the questionnaire.

Although “boomy” and “tinny” are used in the present example, otherdescriptors representing high-frequency and low-frequency gain changesmay also be used (e.g. treble/bass, sharpness/fullness, etc.).

User 104 may be presented with the fine-tuning question using any of theinterfaces listed above (e.g., a speech interface, a remote control oran app on a computer or other smart device). User 104 may respond to thefine-tuning questions using any of the options outlined above (e.g., aspeech recognition, head gestures, manual controls on the hearing aids,tapping the hearing aids, a remote control or an app on a smartphone,tablet, watch, computer or other smart device).

In some examples, refined settings from OTC/DTC users are stored in thecloud. Thus, each BHI score may correspond to a number of refinedsettings. The initial programming could be optimized by considering allthe available refined settings for a given BHI score.

FIG. 10 is a flowchart illustrating an example operation in accordancewith one or more aspects of this disclosure. FIG. 10 may be considered amore general case of FIG. 4. In the example of FIG. 10, a processingsystem (e.g., one or more processors of hearing instruments 102, one ormore processors of computing system 108, processor(s) 208 of hearinginstrument 200, processor(s) 302 of computing device 300, or acombination of two or more of these) may perform actions (1000) through(1004) to determine an initial fitting for hearing instruments 102.

In the example of FIG. 10. the processing system may obtain dataindicating answers of user 104 of hearing instruments 102 to aquestionnaire (1000). For example, the processing system may obtain dataindicating the answers of user 104 to a BHI questionnaire or anotherhearing assessment questionnaire.

Furthermore, in the example of FIG. 10, the processing system maydetermine an initial audiogram based on the answers (1002). Forinstance, the processing system may determine the initial audiogram foruser 104 based on a BHI score for user 104. More generally, in someexamples, as part of determining the initial audiogram based on theanswers, the processing system may determine a score (e.g., a BHI score)corresponding to the answers of user 104. In such examples, theprocessing system may determine coordinate values corresponding to thescore. For instance, the processing system may determine a pair of PTAvalues (e.g., a three-frequency PTA value and a five-frequency PTAvalue) corresponding to the score. In another example, the processingsystem may determine the coordinate value by determining a SRT value anda 5PTA value corresponding to the score. Furthermore, in such examples,the processing system may determine the initial audiogram based ondistances between the coordinate values and coordinate values for aplurality of audiograms.

In some examples, such as the example of FIG. 6, to determine theinitial audiogram based on the distances between the coordinate valuesand the coordinate values for the plurality of audiograms, theprocessing system may, for each respective audiogram of the plurality ofaudiograms, calculate a respective distance (e.g., one of distances 606)for the respective audiogram. The respective distance for the respectiveaudiogram is a distance between a first point (e.g., point 604) and arespective point for the respective audiogram (e.g., one of points 602).The first point has the coordinate values that correspond to the scorecorresponding to the answers. The respective point for the respectiveaudiogram having the coordinate values for the respective audiogram.Furthermore, the processing system may determine a shortest distanceamong the distances for the plurality of audiograms. The processingsystem may determine the initial audiogram based on a closest audiogramin the plurality of audiograms. The distance for the closest audiogramis equal to the shortest distance among the distances for the pluralityof audiograms. For instance, the processing system may determine thatthe initial audiogram is the closest audiogram.

In some examples, the processing system may determine a plurality ofclosest audiograms in the plurality of audiograms. In such examples, thedistances for each of the closest audiograms are equal to the shortestdistance among the distances for the plurality of audiograms.Furthermore, in such examples, the processing system may select theinitial audiogram from among the plurality of closest audiograms basedon which one of the closest audiograms is more prevalent in apopulation. For instance, the processing system may retrieve and comparestored data indicating prevalence values for the audiograms.

In some examples, the processing system may determine a plurality ofclosest audiograms in the plurality of audiograms. In such examples, thedistances for each of the closest audiograms are equal to the shortestdistance among the distances for the plurality of audiograms. In suchexamples, the processing system may determine an average of theplurality of closest audiograms. For instance, the processing system maydetermine, for each frequency band of the closest audiograms, an averageof the thresholds for the frequency band. The processing system may usethe average of the plurality of closest audiograms as the initialaudiogram.

In some examples, to determine the initial audiogram, the processingsystem may identify, based on the answers, multiple audiograms from aset of audiograms, such as a set of standard audiograms. The processingsystem may then determine the initial audiogram based on the multipleidentified audiograms. For instance, the processing system may assignthresholds from the identified audiograms to different frequency bandsof the initial audiogram.

For example, the processing system may identify a first audiogram basedon distances between the 3PTA score for user 104 and 3PTA values of thestandard audiograms. In this example, the first audiogram has a closer3PTA value to the 3PTA score for user 104 than the other standardaudiograms. For ease of explanation, this disclosure may refer to thisfirst audiogram as a 3PTA audiogram. Additionally, in this example, theprocessing system may identify a second audiogram based on distancesbetween the 5PTA score for user 104 and 5PTA values of the standardaudiograms. In this example, the second audiogram has a closer 5PTAvalue to the 5PTA score for user 104 than the other standard audiograms.For ease of explanation, this disclosure may refer to this secondaudiogram as a 5PTA audiogram. Furthermore, in this example, theprocessing system may assign the 500 Hz, 1000 Hz, and 2000 Hz thresholdsof the 3PTA audiogram as the 500 Hz, 1000 Hz, and 1000 Hz thresholds ofthe initial audiogram, and may assign the 3000 Hz and 4000 Hz thresholdsof the 5PTA audiogram as the 3000 Hz and 4000 Hz thresholds of theinitial audiogram.

In another example, the processing system may identify an audiogram fromamong the standard audiograms. For instance, in this example, theidentified standard audiogram may have a closer 3PTA value to the 3PTAscore for user 104 than any of the other standard audiograms. In otherinstances, the identified standard audiogram may have a closer 5PTAvalue to the 5PTA score for user 104 than any of the other standardaudiograms. In still other instances, a Euclidean distance from the 3PTAand 5PTA values of the identified standard audiogram is closer to the3PTA and 5PTA scores for user 104 than any of the other standardaudiograms. Like in the previous example, the processing system mayassign the 500 Hz, 1000 Hz, and 2000 Hz thresholds of the identifiedstandard audiogram as the 500 Hz, 1000 Hz, and 1000 Hz thresholds of theinitial audiogram. However, in this example, the processing system maydetermine an average of the 3000 Hz and 4000 Hz thresholds of theidentified standard audiogram, e.g., using the following formula:

((5-frequency PTA*5)−(3-frequency PTA*3))/2=(3000 Hz hearingthreshold+4000 Hz hearing thresholds)/2

In the formula above, “3-frequency PTA” denotes an average of thethresholds of the identified standard audiogram for 500, 1000, and 2000Hz and “5-frequency PTA” denotes an average of the thresholds of theidentified standard audiogram for 500, 1000, 2000, 3000, and 4000 Hz. Asnoted in the formula above, subtracting 3-frequency PTA*3 from5-frequency PTA*5 and dividing by two is equivalent to the average ofthe 3000 and 4000 Hz thresholds of the identified standard audiogram. Inthis example, the processing system may use the average value of the3000 Hz and 4000 Hz thresholds of the identified standard audiogram andthe slope of the identified standard audiogram to determine values ofthe 3000 Hz and 4000 Hz thresholds of the initial audiogram. Forinstance, in one such example, consider the situation in which theprocessing system has used the formula above and determined that themean hearing threshold at 3000 and 4000 Hz is 60 dB HL. HL in thiscontext refers to hearing loss. The processing system may then use thisinformation to more precisely set the 3000 Hz and 4000 Hz thresholds ofthe initial audiogram.

In some examples, the processing system may do so by determining a slopeof the thresholds of the identified standard audiogram. The processingsystem. may then consider the averaged threshold value as correspondingto a point between 3000 Hz and 4000 Hz (e.g., 3500 Hz or another value).The processing system may then extrapolate the 3000 Hz and 4000 Hzthresholds of the initial audiogram based on the calculated averagevalue and the determined slope. For example, if the identified standardaudiogram has a flat loss (i.e., the slope of the identified standardaudiogram is small), the processing system may set each of the 3000 Hzand 4000 Hz thresholds of the initial audiogram to 60 dB HL. However, ifthe identified standard audiogram has a steep slope, the processingsystem may set the 3000 Hz threshold of the initial audiogram to 45 dBHL and the 4000 Hz threshold of the initial audiogram to 75 dB HL. Ineach of the above examples, frequency bands other than 500, 1000, 2000,3000, and 4000 Hz may be used.

In this way, the processing system may determine an average of a firstfrequency threshold 3000 Hz) of the initial audiogram and a secondfrequency threshold (e.g., 4000 Hz) of the initial audiogram.Furthermore, the processing system may determine a slope for thresholdsof the initial audiogram. The thresholds of the initial audiograminclude the first and second frequency thresholds of the initialaudiogram. In this example, the processing system may extrapolate, basedon the average of the first and second frequency thresholds and theslope, refined values for the first and second frequency thresholds. Theprocessing system may set the first and second frequency thresholds ofthe initial audiogram to the refined values for the first and secondfrequency thresholds, respectively.

In the example of FIG. 10, the processing system may perform an initialfitting of the one or more hearing instruments based on the initialaudiogram (1004). For instance, in examples where the processing systemis implemented in computing system 108, the processing system may send(e.g., using one or more of communication unit(s) 304) instructions toset output parameters of hearing instruments 102 based on the initialaudiogram. In examples where the processing system is implemented inhearing instruments 102, hearing instruments 102 may update outputparameters of hearing instruments 102 (e.g., by changing stored valuesof the output parameters in storage device(s) 202) based on the initialaudiogram.

As noted elsewhere in this disclosure, after user 104 has arrived at arefined fitting (e.g., after one or more rounds of actions 408 and 410in FIG. 4), the processing system may add an audiogram corresponding tothe refined fitting for user 104 to the set of “standard” audiograms andassociate the audiogram corresponding to the refined fitting with the 3-and 5-frequency PTAs corresponding to initially assessed the BHI scorefor user 104. In such examples, the processing system may obtaininformation about listening perception of sound generated by the one ormore first hearing instruments. The processing system may perform arefined fitting of the one or more first hearing instruments based onthe information about the listening perception of the sound generated bythe one or more first hearing instruments. The processing system mayinclude an audiogram corresponding to the refined fitting of the one ormore first hearing instruments in the plurality of audiograms.Subsequently, the processing system may perform a second iteration ofthis process with another, second user. Thus, if the second user has aBHI score similar to the BHI score for user 104, the audiogramcorresponding to the refined fitting may be determined as an initialaudiogram for the second user.

Thus, the hearing instruments, the user, answers, and score associatedwith the earlier iteration may be referred to as the first hearinginstruments, first user, first answers, and first score. For instance,after including the audiogram corresponding to the refined fitting ofthe one or more first hearing instruments in the plurality ofaudiograms, the processing system may obtain data indicating answers ofa second user of one or more second hearing instruments to thequestionnaire. The second hearing instruments are different and separatefrom the first hearing instruments. The questionnaire may be the same asin the first iteration. The processing system may determine a secondscore, where the second score corresponds to the answers of the seconduser. The processing system may determine the second score in the samemanner that the processing system determined the first score.Furthermore, the processing system may determine coordinate valuescorresponding to the second score. The processing system may determinethe coordinate values corresponding to the second score in the same wayas the first score. The processing system may determine a second initialaudiogram based on distances between the coordinate values correspondingto the second score and coordinate values for the plurality ofaudiograms. In addition, the processing system may perform an initialfitting of the one or more second hearing instruments based on thesecond initial audiogram.

In the context of FIG. 10, after the processing system performs theinitial fitting of one or more hearing instruments, the processingsystem may obtain information about listening perception of soundgenerated by the one or more hearing instruments 102. In this example,the processing system may perform a refined fitting based on theinformation about the listening perception of the sound generated by theone or more hearing instruments 102. In some such examples, the answersto the questionnaire may be a first set of answers and, as part ofobtaining information about listening perception of sound generated bythe one or more hearing instruments 102, the processing system mayobtain a second set of answers. The second set of answers are responsesof the first user to questions regarding the listening perception of thesound generated by the one or more hearing instruments 102 afterperforming the initial fitting of the one or more hearing instruments102. The questions regarding the listening perception of the soundgenerated by the one or more hearing instruments 102 include one or moreof: questions regarding an overall loudness of sound generated by theone or more hearing instruments 102, questions regarding a loudnessbalance of the sound generated by the one or more hearing instruments102 when the one or more hearing instruments 102 include two hearinginstruments, or questions regarding whether the sound generated by theone or more hearing instruments 102 is tinny or boomy.

The following is a non-limiting list of examples that are in accordancewith one or more techniques of this disclosure.

EXAMPLE 1

A method comprising: obtaining, by a processing system, data indicatinganswers of a user of one or more hearing instruments to a questionnaire;determining, by the processing system, an initial audiogram based on theanswers; and performing, by the processing system, an initial fitting ofthe one or more hearing instruments based on the initial audiogram.

EXAMPLE 2

The method of example 1, wherein determining the initial audiogram basedon the answers comprises: determining, by the processing system, a scorecorresponding to the answers; determining, by the processing system,coordinate values corresponding to the score; and determining, by theprocessing system, the initial audiogram based on distances between thecoordinate values and coordinate values for a plurality of audiograms.

EXAMPLE 3

The method of example 2, wherein determining the coordinate valuescomprises determining a pair of pure-tone-average (PTA) valuescorresponding to the score.

EXAMPLE 4

The method of example 3, wherein the pair of PTA values includes athree-frequency PTA value and a five-frequency PTA value.

EXAMPLE 5

The method of example 2, wherein determining the coordinate valuescomprises determining a Speech Recognition Threshold (SRT) value and afive-frequency PTA value.

EXAMPLE 6

The method of any of examples 2-5, wherein determining the initialaudiogram based on the distances between the coordinate values and thecoordinate values for the plurality of audiograms comprises: for eachrespective audiogram of the plurality of audiograms, calculating, by theprocessing system, a respective distance for the respective audiogram,the respective distance for the respective audiogram being a distancebetween a first point and a respective point for the respectiveaudiogram, the first point having the coordinate values that correspondto the score corresponding to the answers, the respective point for therespective audiogram having the coordinate values for the respectiveaudiogram; determining, by the processing system, a shortest distanceamong the distances for the plurality of audiograms; and determining, bythe processing system, the initial audiogram based on a closestaudiogram in the plurality of audiograms, wherein the distance for theclosest audiogram is equal to the shortest distance among the distancesfor the plurality of audiograms.

EXAMPLE 7

The method of example 6, wherein the initial audiogram is the closestaudiogram.

EXAMPLE 8

The method of example 6, wherein determining the initial audiogram basedon the closest audiogram comprises: determining, by the processingsystem, a plurality of closest audiograms in the plurality of audiogramsincludes, wherein the distances for each of the closest audiograms areequal to the shortest distance among the distances for the plurality ofaudiograms; and selecting, by the processing system, the initialaudiogram from among the plurality of closest audiograms based on whichone of the closest audiograms is more prevalent in a population.

EXAMPLE 9

The method of example 6, wherein determining the initial audiogram basedon the closest audiogram comprises: determining, by the processingsystem, that the plurality of audiograms includes a plurality of closestaudiograms, wherein the distances for each of the closest audiograms areequal to the shortest distance among the distances for the plurality ofaudiograms; and determining, by the processing system, an average of theplurality of closest audiograms; and using, by the processing system,the average of the plurality of closest audiograms as the initialaudiogram.

EXAMPLE 10

The method of any of examples 2-9, wherein the user is a first user, theone or more hearing instruments are one or more first hearinginstruments, and the method further comprises: obtaining, by theprocessing system, information about listening perception of soundgenerated by the one or more first hearing instruments; performing, bythe processing system, a refined fitting of the one or more firsthearing instruments based on the information about the listeningperception of the sound generated by the one or more first hearinginstruments; and including, by the processing system, an audiogramcorresponding to the refined fitting of the one or more first hearinginstruments in the plurality of audiograms; and after including theaudiogram corresponding to the refined fitting of the one or more firsthearing instruments in the plurality of audiograms: obtaining, by theprocessing system, data indicating answers of a second user of one ormore second hearing instruments to the questionnaire; determining, bythe processing system, a second score, the second score corresponding tothe answers of the second user; determining, by the processing system,coordinate values corresponding to the second score; determining, by theprocessing system, a second initial audiogram based on distances betweenthe coordinate values corresponding to the second score and coordinatevalues for the plurality of audiograms; and performing, by theprocessing system, an initial fitting of the one or more second hearinginstruments based on the second initial audiogram.

EXAMPLE 11

The method of any of examples 1-9, wherein the user is a first user, theone or more hearing instruments are one or more first hearinginstruments, and the method further comprises, after performing theinitial fitting of the one or more first hearing instruments: obtaining,by the processing system, information about listening perception ofsound generated by the one or more first hearing instruments; andperforming, by the processing system, a refined fitting based on theinformation about the listening perception of the sound generated by theone or more first hearing instruments.

EXAMPLE 12

The method of example 10 or 11, wherein: the answers are a first set ofanswers, and obtaining information about listening perception of soundgenerated by the one or more first hearing instruments comprisesobtaining, by the processing system, a second set of answers, the secondset of answers being responses of the first user to questions regardingthe listening perception of the sound generated by the one or more firsthearing instruments after performing the initial fitting of the one ormore first hearing instruments.

EXAMPLE 13

The method of example 10 or 11, wherein the questions regarding thelistening perception of the sound generated by the one or more firsthearing instruments include one or more of: questions regarding anoverall loudness of sound generated by the one or more first hearinginstruments, questions regarding a loudness balance of the soundgenerated by the one or more first hearing instruments when the one ormore first hearing instruments include two hearing instruments, orquestions regarding whether the sound generated by the one or more firsthearing instruments is tinny or boomy.

EXAMPLE 14

The method of any of examples 1-13, wherein determining the initialaudiogram comprises: identifying, based on the answer, multipleaudiograms from a set of audiograms; and determining the initialaudiogram based on the multiple identified audiograms.

EXAMPLE 15

A computing system comprising: one or more computing devices, whereinone or more processors and one or more communication units are includedin the one or more computing devices, the one or more communicationunits are configured to communicate with one or more hearinginstruments, and the one or more processors are configured to: obtaindata indicating answers of a user of the one or more hearing instrumentsto a questionnaire; determine an initial audiogram based on the answers;and perform an initial fitting of the one or more hearing instrumentsbased on the initial audiogram.

EXAMPLE 16

The computing system of example 15, wherein the one or more processorsare configured to perform the methods of any of examples 1-14.

EXAMPLE 17

A hearing instrument comprising: one or more processors configured to:obtain data indicating answers of a user of the one or more hearinginstruments to a questionnaire; determine an initial audiogram based onthe answers; and perform an initial fitting of the hearing instrumentbased on the initial audiogram; and a receiver comprising one or morespeakers for generating audible sound.

EXAMPLE 18

The hearing instrument of examples 15, wherein the one or moreprocessors are configured to perform the methods of any of examples1-14.

EXAMPLE 19

A processing system comprising means for performing the methods of anyof examples 1-14.

EXAMPLE 20

The processing system of example 19, wherein the processing systemincludes one or more hearing instruments.

EXAMPLE 21

A computer-readable data storage medium having instructions storedthereon that when executed cause a processing system to perform themethods of any of examples 1-14.

In this disclosure, ordinal terms such as “first,” “second,” “third,”and so on, are not necessarily indicators of positions within an order,but rather may be used to distinguish different instances of the samething. Examples provided in this disclosure may be used together,separately, or in various combinations. Furthermore, with respect toexamples that involve personal data regarding a user, it may be requiredthat such personal data only be used with the permission of the user.

It is to be recognized that depending on the example, certain acts orevents of any of the techniques described herein can be performed in adifferent sequence, may be added, merged, or left out altogether (e.g.,not all described acts or events are necessary for the practice of thetechniques). Moreover, in certain examples, acts or events may beperformed concurrently, e.g., through multi-threaded processing,interrupt processing, or multiple processors, rather than sequentially.

In one or more examples, the functions described may be implemented inhardware, software, firmware, or any combination thereof. If implementedin software, the functions may be stored on or transmitted over, as oneor more instructions or code, a computer-readable medium and executed bya hardware-based processing unit. Computer-readable media may includecomputer-readable storage media, which corresponds to a tangible mediumsuch as data storage media, or communication media including any mediumthat facilitates transfer of a computer program from one place toanother, e.g., according to a communication protocol. In this manner,computer-readable media generally may correspond to (1) tangiblecomputer-readable storage media which is non-transitory or (2) acommunication medium such as a signal or carrier wave. Data storagemedia may be any available media that can be accessed by one or morecomputers or one or more processing circuits to retrieve instructions,code and/or data structures for implementation of the techniquesdescribed in this disclosure. A computer program product may include acomputer-readable medium.

By way of example, and not limitation, such computer-readable storagemedia can comprise RAM, ROM, EEPROM, CD-ROM or other optical diskstorage, magnetic disk storage, or other magnetic storage devices, flashmemory, cache memory, or any other medium that can be used to storedesired program code in the form of instructions or data structures andthat can be accessed by a computer. Also, any connection is properlytermed a computer-readable medium. For example, if instructions aretransmitted from a website, server, or other remote source using acoaxial cable, fiber optic cable, twisted pair, digital subscriber line(DSL), or wireless technologies such as infrared, radio, and microwave,then the coaxial cable, fiber optic cable, twisted pair, DSL, orwireless technologies such as infrared, radio, and microwave areincluded in the definition of medium. It should be understood, however,that computer-readable storage media and data storage media do notinclude connections, carrier waves, signals, or other transient media,but are instead directed to non-transient, tangible storage media. Diskand disc, as used herein, includes compact disc (CD), laser disc,optical disc, digital versatile disc (DVD), floppy disk and Blu-raydisc, where disks usually reproduce data magnetically, while discsreproduce data optically with lasers. Combinations of the above shouldalso be included within the scope of computer-readable media.

Functionality described in this disclosure may be performed by fixedfunction and/or programmable processing circuitry. For instance,instructions may be executed by fixed function and/or programmableprocessing circuitry. Such processing circuitry may include one or moreprocessors, such as one or more digital signal processors (DSPs),general purpose microprocessors, application specific integratedcircuits (ASICs), field programmable logic arrays (FPGAs), or otherequivalent integrated or discrete logic circuitry. Accordingly, the term“processor,” as used herein may refer to any of the foregoing structureor any other structure suitable for implementation of the techniquesdescribed herein. In addition, in some aspects, the functionalitydescribed herein may be provided within dedicated hardware and/orsoftware modules. Also, the techniques could be fully implemented in oneor more circuits or logic elements. Processing circuits may be coupledto other components in various ways. For example, a processing circuitmay be coupled to other components via an internal device interconnect,a wired or wireless network connection, or another communication medium.

The techniques of this disclosure may be implemented in a wide varietyof devices or apparatuses, including a wireless handset, an integratedcircuit (IC) or a set of ICs (e.g., a chip set). Various components,modules, or units are described in this disclosure to emphasizefunctional aspects of devices configured to perform the disclosedtechniques, but do not necessarily require realization by differenthardware units. Rather, as described above, various units may becombined in a hardware unit or provided by a collection ofinteroperative hardware units, including one or more processors asdescribed above, in conjunction with suitable software and/or firmware.

Various examples have been described. These and other examples arewithin the scope of the following claims.

1. A method comprising: obtaining, by a processing system, dataindicating answers of a user of one or more hearing instruments to aquestionnaire; determining, by the processing system, an initialaudiogram based on the answers, wherein determining the initialaudiogram based on the answers comprises: determining, by the processingsystem, a score corresponding to the answers: determining, by theprocessing system, coordinate values corresponding to the score; anddetermining, by the processing system, the initial audiogram based ondistances between the determined coordinate values and coordinate valuesfor a plurality of audiograms; and performing, by the processing system,an initial fitting of the one or more hearing instruments based on theinitial audiogram.
 2. (canceled)
 3. The method of claim 1, whereindetermining the coordinate values comprises determining a pair ofpure-tone-average (PTA) values corresponding to the score.
 4. The methodof claim 3, wherein the pair of PTA values includes a three-frequencyPTA value and a five-frequency PTA value.
 5. The method of claim 1,wherein determining the coordinate values comprises determining a SpeechRecognition Threshold (SRT) value and a five-frequency PTA value.
 6. Themethod of claim 1, wherein determining the initial audiogram based onthe distances between the determined coordinate values and thecoordinate values for the plurality of audiograms comprises: responsiveto a determination that coordinate values for two or more audiograms inthe plurality of audiograms are equally distant from the determinedcoordinate values, determining which of the two or more audiograms touse as the initial audiogram based on whether the user is a new hearinginstrument user or is currently a hearing instrument user.
 7. The methodof claim 1, wherein determining the initial audiogram based on thedistances between the determined coordinate values and the coordinatevalues for the plurality of audiograms comprises: for each respectiveaudiogram of the plurality of audiograms, calculating, by the processingsystem, a respective distance for the respective audiogram, therespective distance for the respective audiogram being a distancebetween a first point and a respective point for the respectiveaudiogram, the first point having the coordinate values that correspondto the score corresponding to the answers, the respective point for therespective audiogram having the coordinate values for the respectiveaudiogram; determining, by the processing system, a shortest distanceamong the distances for the plurality of audiograms; and determining, bythe processing system, the initial audiogram based on a closestaudiogram in the plurality of audiograms, wherein the distance for theclosest audiogram is equal to the shortest distance among the distancesfor the plurality of audiograms.
 8. The method of claim 7, wherein theinitial audiogram is the closest audiogram.
 9. The method of claim 8,wherein determining the initial audiogram based on the closest audiogramcomprises: determining, by the processing system, a plurality of closestaudiograms in the plurality of audiograms includes, wherein thedistances for each of the closest audiograms are equal to the shortestdistance among the distances for the plurality of audiograms; andselecting, by the processing system, the initial audiogram from amongthe plurality of closest audiograms based on which one of the closestaudiograms is more prevalent in a population.
 10. The method of claim 7,wherein determining the initial audiogram based on the closest audiogramcomprises: determining, by the processing system, that the plurality ofaudiograms includes a plurality of closest audiograms, wherein thedistances for each of the closest audiograms are equal to the shortestdistance among the distances for the plurality of audiograms; anddetermining, by the processing system, an average of the plurality ofclosest audiograms; and using, by the processing system, the average ofthe plurality of closest audiograms as the initial audiogram.
 11. Themethod of claim 1, wherein the user is a first user, the one or morehearing instruments are one or more first hearing instruments, and themethod further comprises: obtaining, by the processing system,information about listening perception of sound generated by the one ormore first hearing instruments; performing, by the processing system, arefined fitting of the one or more first hearing instruments based onthe information about the listening perception of the sound generated bythe one or more first hearing instruments; including, by the processingsystem, an audiogram corresponding to the refined fitting of the one ormore first hearing instruments in the plurality of audiograms; and afterincluding the audiogram corresponding to the mimed fitting of the one ormore first hearing instruments in the plurality of audiograms:obtaining, by the processing system, data indicating answers of a seconduser of one or more second hearing instruments to the questionnaire;determining, by the processing system, a second score, the second scorecorresponding to the answers of the second user; determining, by theprocessing system, coordinate values corresponding to the second score;determining, by the processing system, a second initial audiogram basedon distances between the coordinate values corresponding to the secondscore and coordinate values for the plurality of audiograms; andperforming, by the processing system, an initial fitting of the one ormore second hearing instruments based on the second initial audiogram.12. The method of claim 1, wherein the user is a first user, the one ormore hearing instruments are one or more first hearing instruments, andthe method further comprises, after performing the initial fitting ofthe one or more first hearing instruments: obtaining, by the processingsystem, information about listening perception of sound generated by theone or more first hearing instruments; and performing, by the processingsystem, a refined fitting based on the information about the listeningperception of the sound generated by the one or more first hearinginstruments.
 13. The method of claim 1, wherein: the answers are a firstset of answers, and obtaining information about listening perception ofsound generated by the one or more first hearing instruments comprisesobtaining, by the processing system, a second set of answers, the secondset of answers being responses of the first user to questions regardingthe listening perception of the sound generated by the one or more firsthearing instruments after performing the initial fitting of the one ormore first hearing instruments.
 14. The method of claim 13, wherein thequestions regarding the listening perception of the sound generated bythe one or more first hearing instruments include one or more of:questions regarding an overall loudness of sound generated by the one ormore first hearing instruments, questions regarding a loudness balanceof the sound generated by the one or more first hearing instruments whenthe one or more first hearing instruments include two heatinginstruments, or questions regarding whether the sound generated by theone or more first hearing instruments is tinny or boomy.
 15. The methodof claim 1, wherein determining the initial audiogram comprises:identifying, based on the answers, multiple audiograms from a set ofaudiograms; and determining the initial audiogram based on the multipleidentified audiograms.
 16. The method of claim 1, further comprising:determining, by the processing system, an average of a first frequencythreshold of the initial audiogram and a second frequency threshold ofthe initial audiogram; determining, by the processing system, a slopefor thresholds of the initial audiogram, wherein the thresholds of theinitial audiogram include the first and second frequency thresholds ofthe initial audiogram; extrapolating, by the processing system, based onthe average of the first and second frequency thresholds and the slope,refined values for the first and second frequency thresholds; andsetting, by the processing system, the first and second frequencythresholds of the initial audiogram to the refined values for the firstand second frequency thresholds, respectively.
 17. A computing systemcomprising: one or more computing devices, wherein one or moreprocessors and one or more communication units are included in the oneor more computing devices, the one or more communication units areconfigured to communicate with one or more hearing instruments, and theone or more processors are configured to: obtain data indicating answersof a user of the one or more hearing instruments to a questionnaire;determine an initial audiogram based on the answers, wherein the one ormore processors are configured such that, as part of determining theinitial audiogram based on the answers, the one or more processors:determine a score corresponding to the answers; determine coordinatevalues corresponding to the score; and determine the initial audiogrambased on distances between the determined coordinate values andcoordinate values for a plurality of audiograms; and perform an initialfitting of the one or more hearing instruments based on the audiogram.18. (canceled)
 19. The computing system of claim 17, wherein the one ormore processors are configured to, as part of determining the initialaudiogram based on the distances between the determined coordinatevalues and the coordinate values for the plurality of audiograms: foreach respective audiogram of the plurality of audiograms, calculate arespective distance for the respective audiogram, the respectivedistance for the respective audiogram being a distance between a firstpoint and a respective point for the respective audiogram, the firstpoint having the coordinate values that correspond to the scorecorresponding to the answers, the respective point for the respectiveaudiogram having the coordinate values for the respective audiogram;determine a shortest distance among the distances for the plurality ofaudiograms; and determine the initial audiogram based on a closestaudiogram in the plurality of audiograms, wherein the distance for theclosest audiogram is equal to the shortest distance among the distancesfor the plurality of audiograms.
 20. The computing system of claim 17,wherein the user is a first user, the one or more hearing instrumentsare one or more first hearing instruments, and the one or moreprocessors are further configured to: obtain information about listeningperception of sound generated by the one or more first hearinginstruments; perform a refined fitting of the one or more first hearinginstruments based on the information about the listening perception ofthe sound generated by the one or more first hearing instruments;include an audiogram corresponding to the refined fitting of the one ormore first hearing instruments in the plurality of audiograms; and afterincluding the audiogram corresponding to the refined fitting of the oneor more first hearing instruments in the plurality of audiograms: obtaindata indicating answers of a second user of one or more second hearinginstruments to the questionnaire; determine a second score, the secondscore corresponding to the answers of the second user; determinecoordinate values corresponding to the second score; determine a secondinitial audiogram based on distances between the coordinate valuescorresponding to the second score and coordinate values for theplurality of audiograms; and perform an initial fitting of the one ormore second hearing instruments based on the second initial audiogram.21. A hearing instrument comprising: one or more processors configuredto: obtain data indicating answers of a user of the one or more hearinginstruments to a questionnaire; determine an initial audiogram based onthe answers, wherein the one or more processors are configured suchthat, as part of determining the initial audiogram based on the answers,the one or more processors: determine a score corresponding to theanswers; determine coordinate values corresponding to the score; anddetermine the initial audiogram based on distances between thedetermined coordinate values and coordinate values for a plurality ofaudiograms; and perform an initial fitting of the hearing instrumentbased on the initial audiogram; and a receiver comprising one or morespeakers for generating audible sound.
 22. (canceled)
 23. The hearinginstrument of claim 21, wherein the one or more processors areconfigured to, as part of determining the initial audiogram based on thedistances between the coordinate values and the coordinate values forthe plurality of audiograms: for each respective audiogram of theplurality of audiograms, calculate a respective distance for therespective audiogram, the respective distance for the respectiveaudiogram being a distance between a first point and a respective pointfor the respective audiogram, the first point having the coordinatevalues that correspond to the score corresponding to the answers, therespective point for the respective audiogram having the coordinatevalues for the respective audiogram; determine a shortest distance amongthe distances for the plurality of audiograms; and determine the initialaudiogram based on a closest audiogram in the plurality of audiograms,wherein the distance for the closest audiogram is equal to the shortestdistance among the distances for the plurality of audiograms. 24-25.(canceled)